BCBS Florida Medical Policy Updates – September 2018

Click here to view the Florida Blue Cross Blue Shield Medical Policy Updates »

September 2018 Medical Policy Updates:

• Alpha1-Proteinase Inhibitors (Human)
• Benralizumab (Fasenra)
• Brigatinib (Alunbrig)
• Capecitabine (Xeloda®) Tablets
• Computed Tomography (CT) Spine (Cervical, Thoracic, Lumbar)
• Computed Tomography Angiography (CTA) Chest (non coronary)
• Computed Tomography Angiography (CTA) Upper Extremity
• Dasatinib (Sprycel®) Tablets
• Edaravone (Radicava)
• Electroretinography
• Hip Arthroscopy and Open, Non-Arthroplasty Hip Repair
• Lenalidomide (Revlimid®)
• Rasburicase (Elitek®)
• Ribociclib (Kisqali )
• Voretigene Neparvovec-rzyl (Luxturna)

Added 9/18/2018;

• Abiraterone Acetate (Yonsa , Zytiga ) Tablet
• Apalutamide (Erleada ) Tablet
• Automated Percutaneous Discectomy, Laser Discectomy, Endoscopic Discectomy, or DISC Nucleoplasty™ as Techniques of Intervertebral Disc Decompression
• Bendamustine HCl (Bendeka , Treanda )
• Botulinum Toxins
• Bronchial Thermoplasty
• Chelation Therapy
• Diaphragmatic-Phrenic Nerve Stimulation (i.e., Electrophrenic Pacemaker)
• Drugs and Biologics without a Medical Coverage Guideline (Orphan Drugs and Off-Label and Labeled Use of FDA Approved Drugs)
• Electrostimulation and Electromagnetic Therapy for Treating Wounds
• Enzalutamide (Xtandi®) Capsules
• External Counterpulsation (ECP)
• Functional Neuromuscular Stimulation
• Genetic Testing
• Keratoplasty and Keratectomy
• MCG?mcgId=02-99221-14&pv=false
• Neuromuscular Electrical Stimulation (NMES)
• Orthognathic Surgery
• Oxygen
• Partial Left Ventriculectomy and Surgical Ventricular Restoration
• Positive Airway Pressure Devices
• Positron Emission Tomography (PET)
• Positron Emission Tomography (PET) for Oncologic Applications
• Positron Emission Tomography (PET), Miscellaneous Applications
• Rasburicase (Elitek®)
• Transcatheter Pulmonary Valve Implantation
• Treatments for Varicose Veins/Venous
• Tumor/Genetic Markers
• Vascular Endothelial Growth Factor Inhibitors for Ocular Neovascularization

Click here to view the Florida Blue Cross Blue Shield Medical Policy Updates »

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